Active NPI
Kimberly R Tibbs, MD
- Internal Medicine Physician
- Colorado Springs, CO
National Provider Identifier
1013968346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 39972
- Practice address
- 9480 Briar Village PT
Suite 200
Colorado Springs, CO 80920-7922 - Phone
- (719) 278-3627
- Fax
- (719) 623-2101
- NPI assigned
- May 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 39972 | CO | Primary |
Addresses
Primary practice location
9480 Briar Village PT
Suite 200
Colorado Springs, CO 80920-7922
Mailing address
1901 N Union Blvd
Ste 105
Colorado Springs, CO 80909-7200
Phone (719) 278-3627
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39972 | CO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Interim Healthcare of Southeastern Colorado, Inc | Current | Accepting new patients | |
| University of Cincinnati Physicians Company, LLC | Internal Medicine | Past | Accepting new patients |
| Mountain View Medical Group, PC | Internal Medicine | Past | Accepting new patients |
| Mountain View Medical Group, PC | Past | Accepting new patients |
Locations
1901 N Union Blvd
Ste 105
Colorado Springs, CO 80909
Phone (719) 314-4868
Interoperability endpoints
- https://api.platform.athenahealth.com/1928/brand/1/csg/62/fhir/r4
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505174400000",
"number": "1013968346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 N UNION BLVD",
"address_2": "STE 105",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809097200",
"telephone_number": "719-278-3627",
"fax_number": "719-623-2101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9480 BRIAR VILLAGE PT",
"address_2": "SUITE 200",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809207922",
"telephone_number": "719-278-3627",
"fax_number": "719-623-2101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIBBS",
"first_name": "KIMBERLY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-12",
"last_updated": "2017-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "39972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.